Affordable Safe Housing Means Healthy CitizensHighlights of the Month Friday, September 7th, 2012
Affordable Safe Housing Means Healthy Citizens
By Caryn Sever
In a political landscape wrought with arguments over leadership (in most cases) rather than policy itself, it is difficult to connect the dots between seemingly unassociated initiatives and mandates. Health Affairs accomplishes this very task in their recent article “Health in All Policies: The Role of The US Department of Housing and Urban Development and Present and Future Challenges,”written by Raphael W. Bostic, Rachel L.J. Thornton, Elizabeth C. Rudd, and Michelle J. Sternthal.
A complete understanding of this topic begins, as most do, with a historical context. The U.S. Housing Act of 1937 also known as the Wagner-Steagall Housing Act, was enacted for the following reasons:
- to promote the general welfare of the Nation by employing the funds and credit of the Nation, as provided in this chapter—
- to assist States and political subdivisions of States to remedy the unsafe housing conditions and the acute shortage of decent and safe dwellings for low-income families;
- to assist States and political subdivisions of States to address the shortage of housing affordable to low-income families; and
- consistent with the objectives of this subchapter, to vest in public housing agencies that perform well, the maximum amount of responsibility and flexibility in program administration, with appropriate accountability to public housing residents, localities, and the general public;
The need was clear in a Depression riddled America, more people on the streets or in compromised housing meant unsafe and unsanitary conditions for all, including big business owners, tax payers, and voters. “Slums were thought to breed immorality, disease, and death, and it was believed that better housing would eliminate those ills.” It is true that this act was flawed creating several issues including class and racial segregation; however it was the first solid action in a line of progress that continued to the present day.
1965 marked the creation of the Department of Housing and Urban Development (HUD) as part of Lyndon B. Johnson’s “Great Society” program which fought to end poverty in America. His initiative linked and targeted the health implications between poor housing conditions and poor health in the United States given the vulnerable populations involved; a notion which continued into the 90’s. An example used in the Health Affairs article is the Healthy Homes and Lead Hazard Control, established in 1991 to target indoor environmental health hazards including lead, mold, and unsafe structure/design features. The action contributed to a “70 percent reduction in childhood lead poisoning since the early 1990’s.” In the following years, HUD worked with localities and community organizations to create safe public housing and health care programs.
Today, the Obama Administration has launched a “place-based budgeting” initiative that requires the federal government to consider the geography both physically and culturally, when setting “fiscal priorities.” The goal was to promote funding to help vulnerable communities address inadequate housing, education, public transportation, and poor health. Further efforts include the Neighborhood Revitalization Initiative, which is aimed to “support local communities in developing and obtaining the tools they need to revitalize neighborhoods of concentrated poverty into neighborhoods of opportunity.”  The interagency program the Partnership for Sustainable Communities, a collaboration between HUD, DOT (Department of Transportation), and the EPA (Environmental Protection Agency) outlines six principles of livability:
(1) to Provide more transportation choices
- developing safe and affordable transportation
- reduce dependence on foreign oil by using green technology
i. reducing greenhouse gas emissions
ii. promoting public health
(2) to promote equitable, affordable housing
- expanding location
- using energy efficient choices
- increasing mobility and lowering combined cost of housing and transportation
(3) Enhance economic competitiveness
- employment centers
- educational opportunities
- other services and tools needed by workers or potential workers
(4) Support existing communities
- Targeted federal funding towards existing communities
i. Transit oriented, mixed use development and land recycling
- Community revitalization and public works efficiency investments
- Safeguarding rural landscapes
(5) Coordinate and leverage federal policies and investment
- Aligning federal policy and funding to remove barriers
i. Increase accountability and effectiveness
ii. Smart energy choices
- Locally generated renewable energy
(6) Value communities and neighborhoods
- Enhancing unique characteristics
- Investing in health, safety, and walkable neighborhoods
i. Rural, urban, and suburban
The Strong Cities, Strong Communities Initiative, was developed to “strengthen neighborhoods, towns, cities and regions around the country by strengthening the capacity of local governments to develop and execute their economic vision and strategies.”  The idea is to assist local government by providing access to federal agency expertise and foster public and private sector partnerships. These partnerships will, in conjunction with the local government, “develop comprehensive plans for their communities and invest in economic growth and job creation.”
Programs and initiatives such as these provide the infrastructure, funding, and support needed to create effective, efficient community health programs. The Healthy Food Financing Initiative, developed by the Obama Administration for example, lends aid to support the increase of access to healthy, affordable food while encouraging expansion and development of grocery stores in areas that are virtually “food deserts” (little or no access to grocery stores or fresh food in the area).  This effort would be a difficult reality without the development of community programs and revitalization.
HUD has been keeping a close eye on the connection between health and housing, in an interview with the Robert Wood Johnson Foundation blog New Public Health, Raphaeal Bostic, a Professor at USC and former Assistant Secretary for Policy Development and Research at the U.S. Department of Housing and Urban Development, explained that HUD has been interested in the “intersection between housing and a whole host of other areas – health care, school performance, job attachment” because they seem closely linked in his assessment. HUD’s project “Moving to Opportunity” tracked health benefits as the one of the biggest benefits of affordable, safe housing. This analysis opened the dialogue for HUD. Now they could bring this information to their stakeholders and grantees to aid them in development of programs that included building healthier communities.
The correlation between affordable, safe housing and the health of citizens is not new. It’s not a mystery why a person living in a warm safe space will be healthier than one living on the street or in a slum. It is a quandary why this is not a priority in American politics. Bostic hopes that “the collaborations happening on the national level will eventually diffuse down” remarking “if we integrate health and housing policies at all levels, that will be very exciting.” The reality is that the health of the nation depends upon communities to take action; the action depends upon local representatives providing support, meanwhile, with many of these programs in place, we can only hope that revitalization and health in urban and rural areas increase.